Effectiveness of soft tissue augmentation using subepithelial connective tissue graft in comparison with free gingival graft and no graft for increasing the width of keratinized mucosa around dental implants: a meta-analysis
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20233803Keywords:
Dental implants, Soft tissue augmentation, Free gingival graft, Subepithelial connective tissue graft, Keratinized mucosaAbstract
The soft tissues around dental implants are important to prevent inflammatory peri-implant diseases and ensure the long-term survival of a dental implant. Periodontal plastic surgery has evolved from traditional mucogingival surgery, according to Zuhr et al as a result of the development of subepithelial connective tissue grafts/free gingival grafts. So, the aim of this review was to compare the effectiveness of soft tissue augmentation using subepithelial connective tissue graft in comparison with free gingival graft and no graft for increasing the width of keratinized mucosa around dental implants. The review was according to PRISMA protocol. A comprehensive search of the specialized databases was performed to include the studies. Quality assessment and meta-analysis were carried out. 10 articles included. Two articles evaluated KTW with FGG and SCTG; FGG and no graft (3); SCTG and no graft (5). All the included studies assessed either primary or secondary outcome measures. In the end, it was concluded that for soft tissue volume augmentation, SCTG is a treatment choice for an increase in KTW at implant sites.
Metrics
References
Stefano S, Marco C, Paolo M, Giovanni BG, Carlo M. Clinical Investigation of Mucosal Thickness Stability After Soft Tissue Grafting Around Implants: A 3-Year Retrospective Study Indian J Dent Res. 2010;21(4):
Oh S-L, Masri RM, Williams DA, Ji C, Romberg E. Free Gingival Grafts for Implants Exhibiting Lack of Keratinized Mucosa: A Prospective Controlled Randomized Clinical Study. J Clin Periodontol. 2017;44(2):195-203.
Saeed R, Seyedeh MA, Hooman K. Evaluation of Color and Width of Attached Gingiva Gain In Two Surgical Techniques: Free Gingival Graft And Connective Tissue Graft Covered By Thin Mucosal Flap. A Clin Trial J Dent (Shiraz). 2019;20(4):224-31.
Abdelsamie PM, Elarab AE, Ibrahim RO, Rahman ARA. Facial Gingival Level Evaluation with And Without Connective Tissue Graft Using Tunnel Technique on Single Immediate Implants in The Esthetic Zone: A Randomized Controlled Clinical Trial. J Osseointegration Ariesdue. 2022;14(2):69-80.
Thoma DS, Buranawat B, Hammerle CHF, Held U, Jung Re. Efficacy of Soft Tissue Augmentation Around Dental Implants and In Partially Edentulous Areas: A Systematic Review. J Clin Periodontol. 2014;41(15):S77-91.
Jeffrey TH. A Prospective Randomized Clinical Trial to Compare Free Gingival Grafts and Connective Tissue Grafts Around Implants With A Lack Of Keratinized Mucosa. The University of Alabama at Birmingham ProQuest Dissertations Publishing. 2017;10287693.
Zaklina M, Oliver D, Mirjana P, Spiro S, Vancho S, Gordana P. Free Gingival Graft Versus Mucro-graft: Histological Evaluation. Open Access Maced J Med Sci. 2018;6(4):675-9.
Lin GH, Chan HL, Wang HL. The Significance of Keratinizedmucosa on Implant Health: A Systematic Review. J Periodontol. 2013;84(12):1755-67.
Becker W, Becker BE, Newman MG, Nyman S. Clinical and Microbiologic Findings That May Contribute to Dental Implant Failure. Int J Oral Maxillofac Implants. 1990;5(1):31-8.
Ostman PO. Immediate/Early Loading of Dental Implants. Clinical Documentation and Presentation of A Treatment Concept. Periodontol 2000. 2008;47:90-112.
Roccuzzo M, Grasso G, Dalmasso P. Keratinized Mucosa Around Implants in Partially Edentulous Posterior Mandible: 10-Year Results of A Prospective Comparative Study. Clin Oral Impl Res. 2015;27(4):1-6.
Chaoling Z, Shimin W, Hongqiang Y, Yunsong L, Wenjie H, Yongsheng Z. Effect of Free Gingival Graft Before Implant Placement on Peri-Implant Health and Soft Tissue Changes: A Randomized Controlled. Trial Bmc Oral Heal. 2021;21:492.
Roccuzzo M, Gaudioso L, Bunino M, Dalmasso P. Surgical Treatment of Buccal Soft Tissue Recessions Around Single Implants: 1-Year Results from A Prospective Pilot Study. Clin Oral Impl Res. 2013;25(6):641-6.
Stefano S, Marco C, Paolo M, Giovanni BG, Carlo M. Clinical Investigation of Mucosal Thickness Stability After Soft Tissue Grafting Around Implants: A 3-Year Retrospective Study Indian. J Dent Res. 2010;21(4):2010.
Shuji Y, Joseph YK, Kitichai R, Philip R, Jaime LL. Effect of Connective Tissue Grafting on The Facial Gingival Level Following Single Immediate Implant Placement and Provisionalization in The Esthetic Zone: A 1- Year Randomized Controlled Prospective Study. Int J Oral Maxillofacial Implants. 2014;29(2)432-40.
Kitichai R, Joseph YKK, Shuji Y, Taichiro M, Grenith Z. Immediate Implant Placement and Provisionalization with And Without a Connective Tissue Graft: An Analysis Of Facial Gingival Tissue Thickness. Int J Periodont Restorative Dentistr. 2012;32(6):197-217.
Islam S, Suzan S. Evaluation Oof Using Connective Tissue Graft as A Biological Barrier to Cover Immediately Placed Implants in Maxillary Anterior Region. Int J Dental Sci Res. 2017;5(3):39-48.
Ali H, Roozbeh S, Seyed AV, Pooyan SE. Free Gingival Graft Immobilization: A Pilot Study on A Newly Designed Stent. J Oral Implantol. 2010;36(2):123-30.
Migliorati M, Amorfini L, Signori A, Biavati As, Benedicenti S. Clinical and Aesthetic Outcome with Post-Extractive Implants with Or Without Soft Tissue Augmentation: A 2-Year Randomized Clinical Trial. Clin Implant Dent Relat Res. 2015;17(5):983-95.
Bengazi F, Lang Np, Caroprese M, Urbizo Velez J, Favero V, Botticelli D. Dimensional Changes in Soft Tissues Around Dental Implants Following Free Gingival Grafting: An Experimental Study in Dogs. Clin Oral Implants Res. 2015;26(2):176-82.
Kirmani M, Zia A, Ahad A, Bey A. Hard-And Soft-Tissue Augmentation Around Dental Implant Using Ridge Split and Connective Tissue Graft for Esthetic Rehabilitation of Atrophic Anterior Maxilla. J Indian Society Periodontol. 2018;22(6):555.
Rojo E, Stroppa G, Sanz‐Martin I, Gonzalez‐Martín O, Alemany As, Nart J. Soft Tissue Volume Gain Around Dental Implants Using Autogenous Subepithelial Connective Tissue Grafts Harvested from The Lateral Palate Or Tuberosity Area. A Randomized Controlled Clinical Study. J Clin Periodontol. 2018;45(4):495-503.
Trombelli L, Simonelli A, Minenna L, Rasperini G, Farina R. Effect of A Connective Tissue Graft in Combination With A Single Flap Approach In The Regenerative Treatment Of Intraosseous Defects. J Periodontol. 2017;88(4):348-56.
Parvini P, Galarraga‐Vinueza ME, Obreja K, Magini RD, Sader R, Schwarz F. Prospective Study Assessing Three‐Dimensional Changes of Mucosal Healing Following Soft Tissue Augmentation Using Free Gingival Grafts. J Periodontol. 2021;92(3):400-8.
Golmayo P, Barallat L, Losada M, Valles C, Nart J, Pascual‐La Rocca A. Keratinized Tissue Gain After Free Gingival Graft Augmentation Procedures Around Teeth and Dental Implants: A Prospective Observational Study. J Clin Periodontol. 2021;48(2):302-14.
Zeltner M, Jung Re, Hämmerle Ch, Hüsler J, Thoma Ds. Randomized Controlled Clinical Study Comparing a Volume‐Stable Collagen Matrix To Autogenous Connective Tissue Grafts For Soft Tissue Augmentation At Implant Sites: Linear Volumetric Soft Tissue Changes Up To 3 Months. J Clin Periodontol. 2017;44(4):446-53.
Chung S, Rungcharassaeng K, Kan JY, Roe P, Lozada JL. Immediate Single Tooth Replacement with Subepithelial Connective Tissue Graft Using Platform Switching Implants: A Case Series. J Oral Implantol 2011;37:559-69.
Tsuda H, Rungcharassaeng K, Kan JY, Roe P, Lozada JL, Zimmerman G. Peri-Implant Tissue Response Following Connective Tissue and Bone Grafting in Conjunction with Immediate Sigle Tooth Replacement In The Esthetic Zone: A Case Series. Int J Oral Maxillofac Implants. 2011;26:427-36.
Maeda Y, Miura J, Taki I, Sogo M. Biomechanical Analysis on Platform Switching: Is There Any Biomechanical Rationale? Clin Oral Implants Res. 2007;18:581-4.